Sprengel 変形に対して V-osteotomy を施行した 2 例の報告

抄録

While functional results of Wilkinson's scapular osteotomy for Sprengel deformity were satisfactory without any neurological complications, we have reported persistent downward rotation of the scapula, which was related to symptomatic multidirectional instability of the shoulder after the operation. This led us to try to perform a modified Wilkinson's osteotomy, additionally with cranial closing wedge resection (V-osteotomy). Here, we reported the short-term radiological and clinical outcome of V-osteotomy in two cases. We evaluated the upward or downward rotation of the scapula with a rotation angle of the scapula (RAS), which was defined as the angle between longitudinal axis of the glenoid and the line perpendicular to the horizontal plane and it was defined as positive when the glenoid faced the superior direction. Case 1 was a two year old girl. Before the operation, shoulder motion was 100° in forward flexion. Cavendish grade was 3, and RAS was -22° before the operation. We performed V-osteotomy. Seventeen months after the operation, shoulder motion was 160° in forward flexion. Cavendish grade was 1 and, RAS was 16°. Case 2 was a two year old boy. One year and nine months after V-osteotomy, shoulder motion increased from 120° to 165° in forward flexion. Cavendish grade improved from 3 to 1. RAS increased -1° to 21°. We concluded that upward rotation of the scapula was successfully achieved by V-osteotomy in these two cases.